Geospatial Mapping Confirms The Stress Of Urban Blight And Other Public Health Problems

For years, we have been tracking and bemoaning the rising cost of healthcare in the United States, and legislators and policy makers have been doing everything they can think of to bring these escalating costs under control. Most of these efforts are focused on limiting access to care through rationing by another name, and by providing that care more efficiently.

Some people have focused on the underlying health of Americans as a big part of the problem. Hey, if we all stopped smoking, drinking, eating foods that are unhealthy, and got off the couch other than to run to the refrigerator between time outs, then maybe we would live longer, healthier lives with less need for costly medical intervention?

But what if our collective environment could be improved at a far lower aggregate cost? What if we had the technological and analytical tools to measure environmental health impacts . . . but we weren’t using them? That would be a real shame, wouldn’t it?

* * * * *

A recent article in the American Journal of Public Health found in a randomized study conducted by doctors at the Perelman School of Medicine at the University of Pennsylvania that African-American pedestrians in Philadelphia who walked by a dilapidated urban lot filled with trash and overgrown vegetation had an elevated heart rate attributed to stress, as compared with those who sauntered past a newly green lot in the same vicinity. The authors noted that this was the first so-called “neighborhood walking trial” in which a physiological marker was measured in real time for those in their regular environment, and the lowered heart rates measured suggests a biological link between vacant lot greening and a reduction in the acute stress of inner city living.

Tourists wait to have a photograph taken in front of the LOVE sculpture at Love Park in Philadelphia, Pennsylvania, U.S., on Saturday, May 9, 2015. Philadelphia, the largest city in the Commonwealth of Pennsylvania, is the center of the state's economic activity as well as home to seven Fortune 1000 companies. Photographer: Victor J. Blue/Bloomberg

When Philadelphia Mayor Michael Nutter goes to the City Council to present his budget, I would imagine that he would need first to weigh the cost of greening vacant lots in North Philadelphia against the extraordinary demands that face the city in many other areas, everything from the cost of cleaning up a snowy winter to improving the desultory state of Philly’s schools. But would the Mayor and the Council even consider the possibility that measurable health and welfare benefits flow from greening, and further consider that the collective costs of healthcare for some portion of the city’s residents might decline over time if the funds could be found to make that investment in the environment today?

It’s worth considering, but it can only be considered if you have the ability to conduct the aforementioned study and establish the basis for the policy discussion. While it is fairly easy to measure walking heart rate changes with a GPS-enabled heart rate monitor, this study could not have done without the use of geospatial systems information software made by Esri, a company based in Redlands, California that makes its software available at no charge to more than 11,000 NGOs. The software enabled the researchers to measure precisely the changes in heart rate averages across the walk on the basis of visual exposure to a trashy lot, a green lot or neither of the above.

Esri’s software mapping technology has other public health applications. For example, in our nation’s capital physicians at Children’s National Health System noticed a disturbing pattern of very young children showing up in the ER with thermal burns. When they used the Esri digital maps to document the residential pattern of victims, they found a distinct cluster in a majority Hispanic neighborhood with many parents who did not have a strong command of English. The core of the problem was very simple: the warning labels affixed to hot water heaters as to temperature control were all in English and needed to be translated into Spanish to prevent the accidental scalding during baths. DC’s Office of Latino Affairs produced leaflets in Spanish that described prevention tips, and the incidence rate dropped dramatically. The technology needed to elucidate the cause of the problem is not so simple, but it is readily available, and therein lies the rub.

Esri executive Dr. Este Geraghty faults state and local government officials for failing to recognize the gold mine that exists in demographic data and mapping software. “Spatial thinking does take a little practice,” she said, noting that on more than one occasion she has had to inform those asking if they can access the technology that they already own it.

This is another example of how we can leverage Big Data to improve health and reduce costs that are now endemic in the system. The State of Arizona is working to improve the quality of foster home care, and is using geospatial mapping to identify those neighborhoods where there is a history of complaints to guide considerations of the optimal environment for placements.

A playground stands at WaterEdge Residences in Senibong Cove, developed by Walker Corp., in Iskandar, Johor, Malaysia, on Saturday, Aug. 16, 2014. Billionaire Lang Walker, founder and executive chairman of Walker Corp., with A$12 billion ($11.2 billion) of planned property projects, said he is looking to increase investments in the Johor region in southern Malaysia after putting in about A$2 billion in the Senibong Cove project. Photographer: Bryan van der Beek/Bloomberg

In another case, a company called KaBOOM! used digital mapping software to identify the presence of “play deserts” – areas that are bereft of playgrounds and recreational opportunities within walking distance of children. Then they set out to fill the void. And it’s quite a void, as 69% of low-income parents report that there is no playground in their neighborhood; in areas without a park in the vicinity children are 26% more likely to be obese. The data does not lie, and by making the case that play and exercise are essential to long-term health, the KaBOOM! folks have been convincing local government officials to invest in parks and playgrounds.

Open data, geospatial mapping and analytics can influence public policy in myriad ways that improve health and reduce societal costs. But the thing is, we have to use it to realize the benefits.